Chronic hepatitis C-related cryoglobulinaemic vasculitis manifesting as non-healing skin ulcers: a case presentation

Aim This paper presents a single case study of hepatitis C virus (HCV)-related cryoglobulinaemic vasculitis (CV) manifesting as non-healing skin ulcers (CV-SU). It discusses ulcer characteristics and management, and highlights the impact of quality of life (QoL) issues faced by the patient. Background Mixed CV is an extrahepatic immune complex-mediated manifestation of HCV. Vasculitides (cryoglobulins) deposit in the endothelium of small to medium blood vessels in the skin and can lead to ischaemia, necrosis, and SUs or lesions. Cryoglobulins precipitate at temperatures below 37 degrees C, generally in the lower extremities, and redissolve on rewarming. Clinical features include palpable purpura, arthralgia, asthenia and SUs. In severe cases, vasculitis may extend to the lungs, kidneys and nerves. Methodology The methodology is a descriptive single case study of a 44-year-old male presenting with HCV-induced CV and refractory lower leg ulcers (CV-SU). Conclusion The management of CV-SU is complex. Resolution requires eradication of HCV, suppression of B cell clonal expansion and cryoglobulin production, and symptom management. The patient's story highlights the importance of understanding and appreciating the lived experience of the condition and the impact of their QoL.